Australia's decision on two proposals on the table at Trans Pacific Partnership negotiations will be critical in determining health outcomes for low-income Australians and those in developing countries in our region, writes Deborah Gleeson.

The draft intellectual property text from the Trans Pacific Partnership Agreement negotiations, released by Wikileaks last week, confirms many of the fears of Australian public health advocates.

The leaked text, dated August 30, 2013, shows that the United States is continuing to push for extreme intellectual property privileges that would expand and prolong patent monopolies at the expense of affordable access to medicines.

Keeping medicines under patent for longer means paying more for drugs. But who would bear this cost? In Australia, medicines are subsidised through the Pharmaceutical Benefits Scheme, which has an uncapped budget. Increasing expenditure on pharmaceuticals might initially be absorbed by allocating a bigger share of the health budget to the PBS, but in the longer term this would be unsustainable. At least part of the extra cost - perhaps all - would have to eventually be passed on to consumers.

Concession card holders currently pay $5.90 per prescription for a PBS-listed drug. This is already a significant burden for people on low incomes, particularly those with chronic illnesses who need to fill several prescriptions each month. With even a small increase in the patient contribution for PBS medicines, many pensioners and disadvantaged Australians may find they need to postpone purchasing much-needed medicines, or go without.

But will Australia join the US as perpetrator, or support the efforts of other countries to strike a better balance between intellectual property privileges and the public interest? The leaked text provides few answers. The text shows the negotiating positions of all twelve parties, and it is clear that the previous Australian Government opposed many of the worst American proposals for pharmaceutical patents. For example, the text indicates that before the election, Australia was rejecting proposals to extend patent periods to compensate for delays in regulatory approval and to extend the length of time before generic manufacturers can use clinical trial data produced by the original manufacturer to register their products for sale.

Australia's silence on key elements of the counter-proposal may be due, at least in part, to the caretaker period in the lead up to the election. But Australia appears to have supported a US proposal to require countries to allow patents for new uses and new methods of using existing products. This calls into question even the previous Government's commitment to preserving access to medicines in the region. The US proposal for patents for new uses and new methods is consistent with current Australian patent law, but would encourage evergreening of patents in other TPP countries, including Vietnam, which already has significant problems providing access to medicines for much of its population.

The US proposals for the TPP are far more extreme than the intellectual property provisions Australia accepted in its bilateral trade agreement with the US. We would hope, particularly given Robb's statement affirming the PBS last week, that the government would reject all provisions that would add significantly to pharmaceutical expenditure in Australia.

But Australia's intellectual property standards are already closer to those of the US than many of the other countries negotiating the TPP. And the success of the counter-proposal may well depend on what position Australia ultimately takes.

With two very distinct proposals on the table, which will Australia support? The ultimate outcome for low-income Australians and the hundreds of thousands of people in the region who struggle to pay for medicines - or die for the lack of them - may to a large degree depend on which direction Australia takes from this point on.

But due to the secrecy of the negotiations, we may still be guessing until after the agreement is signed.

Dr Deborah Gleeson is a lecturer in the School of Public Health and Human Biosciences at La Trobe University. View her full profile here.

MJLC:

20 Nov 2013 3:23:09pm

"Australia's silence on key elements of the counter-proposal may be due, at least in part, to the caretaker period in the lead up to the election"

I have no doubt Dr Gleeson will find it easier from now on to know what's happening. I expect weekly briefings with a 3-star general present to update us on Operation Sovereign Aspirins. Of course, any on-counter matters won't be canvassed as this could compromise national security and assist tablet smugglers peddle their vile generic product - and if a boatload of pills lands at Darwin the government will neither confirm nor deny it.

Things may have just gotten a good deal trickier if it turns out the medication is transiting through Indonesia though...

Observer:

20 Nov 2013 3:48:47pm

The govt must take the people into it's confidence and explain what is proposed before it is signed, even subject the decision to a referendum, because otherwise the people have no say in what is happening, and it cannot be undone. I'm sorry, but I can't afford to trust politicians and public serpents to act openly in the interests of all Australians. The US never negotiates fairly, nor on even grounds, and what's best for US interests always prevails. It will cost us far more than it will cost them, in plain $$. They have a much larger population/tax base to absorb the costs with. Thanks, but no thanks from me.

kenj:

20 Nov 2013 8:27:32pm

",,,,it cannot be undone."

Don't believe what politicians tell you on that one. It is a treaty signed by a sovereign nation and we can withdraw from it at any time. That's not to say that other signatories won't bring external political pressure to bear but there is no impediment to any later withdrawal from the TTP. That being said we would be mugs to sign up for this load of junk which egregiously usurps our judicial system for dealing with commercial disputes. The very idea that this treaty is being negotiated in secret is an absolute outrage.

jim:

21 Nov 2013 2:10:34am

Sovereignty is over ridden in this contract. Australians sovereignty is already being middlemanned by govt and corporations. Under the terms foreign corporates can sue social securities and public service out of existence. With the US jail system here you will also get no help against the terms as much of the power is interlocked if they can pull it off. As owned representation lives it up and under forcings of their owners, the pace of life will quicken at their will and whim under all manner of excuse for profit and overempowerment. This is not a proposal or a trade deal, it is an assault.

kenj:

21 Nov 2013 10:23:47am

Jim, it is true that Australia cedes certain judicial powers under this treaty but it is still the case that Australia has a legal entitlement to withdraw if they choose to do so just as they can from any other international treaty.

Mycal:

20 Nov 2013 4:00:44pm

Before we sign the TTP the "agreed" draft should be published for review for a reasonable (30 - 90 days) of public review. There is really no justification for holding the negotiations in secret but given that has occured the people of all participating nations need to be given the opportunity to at least review it. I would like to see some serious modelling of the benefits and disadvantages before we sign it. I also would like to see a a formal review period included in the Treaty to evaluate its success.

That said, the negotiating positions of participants are just that, opening positions for the purposes of arriving at a mutually beneficial and agreeable trade arrangement.

supermundane:

20 Nov 2013 6:53:15pm

As you know, there's a reason why they don't want these critical agreements open to public review and scrutiny whilst on the other hand, the likes of Monsanto, Walmart, Cargill, GE, Kraft et al have been privy to them and have representation at the table.

Put simply, the agreement isn't in our interests and those negotiating the agreement don't represent us despite the theatrics.

This isn't about free-trade. It's the same kind of marketing spin that claims there is such as thing as 'clean' coal. This is about those individuals and corporations using the existing structures and apparatus of the nation state to lock us into a permanent position of subservience while they, through these same agreements operate globally and are answerable to no-one. This is the global corporations getting to write the rules for global governance under them and this is the global coporations seeking to stake claims on absolutely anything that remains in the commons - to transform absolutely everything into capital for their benefit.

Sack:

Ralph:

21 Nov 2013 3:57:17pm

Unfortunately I have to agree with you, these secret trade deals do the general population no good. Both sides of politics bow down to the mighty corporations and take their brown paper bags in order to sell us out.

supermundane:

20 Nov 2013 7:04:53pm

By which time the damage is done.

I would ask people to consider how the issue of globalised automated, dragnet surveillance of every person on the planet as has been exposed by the Snowden revelations and these so-called 'free-trade' agreements are part-and-parcel of an emerging phase of globalisation that in the end doesn't bode well for most of the population of the planet.

These 'free-trade' agreements are effectively a inexorable move towards global governance by corporations working behind the veneer of once sovereign nations-states. The emerging global surveillance network is but one of the critical mechanisms being put into place to defend emerging world order. It's about ensuring that no mass-movement however global could ever threaten it because thanks to a tendency towards total information and awareness, predictions about beheviour and intent can be made by increasingly intelligent system largely opaque to us.

Parliamentary democracy meanwhile will increasingly degenerate into theatrics. Meaningful policy changes will be impossible if they're proscribed by the global agreements and courts established by and for the corporations. Policies that of a social good (pertaining to public health, work-conditions, the environment, nationalising industries et al, protecting the commons and public institutions) will invariably fall foul of these agreements.

Rusty:

casewitscience:

20 Nov 2013 4:32:57pm

This is just another Defence Trade Controls Act. Don't know what that is? Well, if you are an academic collaborating with Chinese scientists, then just wait for the federal agents to tell you at 3 in the morning as they are dragging you down to an arraignment.

Seano:

20 Nov 2013 4:44:33pm

I hope this has no effect in retrospect with currently generic drugs like salbutamol (eg. Ventolin). I've been buying it over the counter for $5.95 (generic Asmol) in Fremantle since Easter. Cost at the local chemist $7/95 and $8.95 for genuine Ventolin original flavour. Can you imagine what it would cost over the counter if Ventolin was the only option? I've averaged 28 hours per Asmol/Ventolin in the last six months, so the difference between $5.95 and $10.95, which is what they ask for in one North Fremantle place I had to stop by a few years ago, does tend to become of some significance between fortnights.

As for the latest craze in asthma products, 'relievers', they're usually S4 so you couldn't get them over the counter for $5.95 at discount pharmacies in your state or territory, without a script. So your monthly medical expenses now involve seeing a GP, and whether or not you're on a healthcare card, there's usually some subsidy involved when it's still patented, as far as I remember. I've been importing my old-fashioned 'preventer' from overseas since 2010 so some things might have changed here.

maggie:

21 Nov 2013 7:43:36am

Go by a salt pump from salt therapy cost 45.00 and it lasts 6 months or more used properly and you wont need any of the other meds. do an internet search for nearest salt therapy and reap the rewards. From a salt pump user free of meds.

Joe:

20 Nov 2013 5:22:20pm

The Government has not been funding these meds for years. Other countries can do it. It would all be covered under the PBS. Australians have been denied access to the best treatments available and the few that make it here are at below cost of development price...

supermundane:

20 Nov 2013 7:23:53pm

A graver threat to the Australian people is the implementation of the USA's demand for patent coverage of plants and animals, including ?biological processes for the production of plants and animals". Article QQ.E.1 from the draft.

This is one of but many disturbing and dystopian provisions on the table that threaten civil society and undermine corporate accountability.

Also there is also the provision that enables corporations to sue the Australian Government (and by extension, us) in arbitration tribunals stacked corporate lawyers for damages and to undo acts, reforms and regulations that are perceived to threaten their bottom line even if such acts have received public sanction through the democratic process. Environmental protections for example, that threaten the bottom line of some global corporate entity would be potentially subject to such legal challenges without recourse from the Australian people.

Joe:

20 Nov 2013 5:04:28pm

Australia cannot continue to scap off the efforts of the Pharmaceutical industry in the US? We try to buy their hard earned new discoveries for cheap. Time for the PBS to start paying the real price for these drugs and stop vilifying pharmacists and the pharmaceutical industry!!!!

AJC:

20 Nov 2013 5:38:11pm

Why? The USA pharmaceutical industry is just trying to rip off everyone else anyway. They keep foisting on the public new drugs that cause more problems, lie about the side-effects, cover up and bias the research, and have done a grand job of corrupting the FDA in the USA to the point that little of what they say about "Safe" can be trusted.

Joe:

20 Nov 2013 6:58:23pm

....many of these so-called discoveries are merely minor and incremental changes to ensure 'evergreening'...

Wrong. Wild generalisation?We have the PBAC to ensure that drugs listed on the PBS are cost-effective. You can't expect to have the Pharmaceutical Industry fund the majority of the research out there and then expect to garner the hard earned results for cheap? It's for the common good to have a viable Pharmaceutical Industry?

AndrewH:

Joe:

20 Nov 2013 8:50:36pm

I am a pharmacist. Paid from PBS budget, but mostly from paying customers. Not paid directly from Pharmaceutical Industry.

Have a special interest in Clinical trials and Oncology. Deal everyday helping people try to fund medication that is funded overseas but not in Australia. I deal with Pharmaceutical companies organising meds for people with advanced cancer and get to see them live the remainder of their lives to the fullest. There are sooo many inefficiencies in the PBS (red tape to appease a few fringe dwellers) that I find it almost criminal that many medications that are not funded under the PBS or via some alternative PBS/Patient/Drug company co-payment scheme. For example, drug company funds 1 month of medication and if it works, then taxpayer covers. If it fails, then nothing lost. Why not have a proper discussion?

We need a transparent agreement with our friends in the US? If we refuse to pay a proper agreed price of meds, then the mass of discoveries of biological targets will never lead to anything?

Kevins:

21 Nov 2013 2:43:23pm

Joe, How many Australian drug discoveries were made by the CSRIO whose funding is provided by the Australian taxpayer? How many were as a result of University research units, again funded by the Australian taxpayer. Only for foreign owned pharmaceutical corps to patent the discoveries and hence reap the profits? It started with Asprin way back remember?

The PBS is am bulk purchaser and uses its buying power to negotiate best price. Often when these drugs are listed by the PBS and hence Australians obtain subsidised prices, many months even two years have gone by. Pharmaceutical companies make their greatest profit in the first twelve months of the release of a new drug.

Waste in the PBS is huge. For instance how many times does a doctor prescribe a medication that is either ineffectual or causes such high side effects that a new prescription and cost to the PBS has to be met, along with the patient having additional doctors bills as a result? The claims by the drug are below par and insufficient research is being done these days before the drugs receive FDA approval. The reality is that most of the trialling and testing work is actually being done by the patients who routinely prescribed these new medications as part of a normal consultation with their doctor. The doctors then report the success or otherwise to drug reps. Its real scientific this marketing strategy the pharma corps. You expect the Australian taxpayer to pay more for being real time guinea pigs?

supermundane:

20 Nov 2013 8:14:16pm

Not wrong.

Ideally, I'd say it would be preferable to dispense with profiteering in the realm of health altogether. Non-profit research only into pharmaceuticals and potential cures would likely see even greater innovation in that realm without the countless variants of the same drug and 'illnesses' that the pharmaceutical industry's marketing departments concoct in order to shift product.

Joe, your shilling for the pharmaceuticals industry is unlikely to garner mass-support and popular sentiment but a valiant effort nonetheless.

Aria:

20 Nov 2013 11:10:00pm

The market system is nice and efficient when it works, but capitalism is driven by the profit motive - no denying that. It's all fine when what the profit motive decides aligns with what is good for people, but when it doesn't, that's a problem.

supermundane:

21 Nov 2013 5:46:23pm

And without appropriate protections and provisions established the state on behalf of the people - in this case the PBS - the profit motive more often than not aligns only with what is good for a very select group of people at the expense of the majority.

The efficient markets theory has been thoroughly debunked by the events of the past 5 years and yet some like Joe cling fast to it.

struck dumb:

21 Nov 2013 11:20:05am

Joe, I hope you never suffer from a chronic illness that will one day threaten your life! THEN you will understand how the PBS keeps many of us living productive lives contributing to the well being of the society we live in. Being on a disaibility payment does not make us bludgers, but it does often give us the choice between the medication we need to live, and paying for other amenities like power that also helps us stay alive.Or would you have us die a miserable death because we can no longer afford to stay alive? We have the RSPCA to protect animals in that situation, its a criminal offense to deprive an animal of urgent medical help, so its reasonable to expect the government to represent our interests, even if you don't.

AJC:

20 Nov 2013 5:35:23pm

The habit of making a total hash of things seems a little too common in the Obama administration in the USA, and I've seen even less evidence of knowledgeable commonsense in any of the previous radical copyright proposals and anit-piracy proposals of the past two decades. From what I've read so far about the TPP, the secrecy involved gives no confidence that it will result in anything good at all. It looks to me like a gigantic step backwards for innovation, and a giant leap off a cliff for greedy money-junkies who are so mad for controlling more wealth, they shoot themselves in the foot trying to get it.

Jimmy Necktie:

20 Nov 2013 5:54:08pm

Surely if we tried we could come to some arrangement where the pharma's get protected worldwide patents on the condition they provide drugs, worldwide, at an agreed price. Developed countries would pay more and poor countries pay less. The patent would extend to any new drugs as well so R&D would continue.

magb1:

20 Nov 2013 7:03:43pm

With secret squirrels LNP in power, looks like the Australian people will be up the creek without a paddle with the TPP. They have no conscience in doing what will be best themselves and all their big business cronies eg multinationals, Rupert and big end of town.

Rusty:

supermundane:

21 Nov 2013 5:38:21pm

Rusty, who cares which political party commenced these discussions? The problem is that both major political parties are too willing to the bidding of the United States. Neither take a line in foreign policy and trade that is sufficiently independent.

The problem is that there are things on the table which gravely threaten Australian sovereignty and the well-being of the Australian people. Both parties must reject the TPP.

ru4real:

21 Nov 2013 1:14:16am

If '... The leaked text, dated August 30, 2013, shows that the United States is continuing to push for extreme intellectual property privileges that would expand and prolong patent monopolies at the expense of affordable access to medicines', then quite simply the Australian government should not sign up to it. The government has a responsibility to its own population, and this includes negotiating terms in all international agreements so that citizens are not forced to pay outlandish prices for medications.

chrispin:

21 Nov 2013 8:01:20am

So far there?s no such a thing as a free trade agreement, just trade deals. So can we just call them that, as this author has done.

When we sign one of these deals we seem to give away a lot, especially in intellectual property and get very little in return. I guess our problem is that our markets are so open anyway that we have a weak bargaining position. In spite of all the trade deals we signed we have very limited export opportunities except for minerals of course. Even wheat is a struggle competing against subsidised competitors.

Another problem is that most of our potential export industries are foreign owned. We used to sell a lot of manufactured food into South East Asia but on a recent trip, the only Aussie food I could find on the supermarket shelves was Weetbix. Everything else was from Europe and the USA. Perhaps that is one of reasons they bought out our brands ? eliminate the competition.

Our car industry has always had the problem of foreign ownership.

So of the 3 problems we face: limited access to markets, subsidised competitors and foreign ownership, a trade deal only addresses the first.

oneman:

21 Nov 2013 8:10:26am

Ironic that the U.S. takes such a strong stance on intellectual property rights when they are thieving information on a massive scale worldwide. As usual its about maintaining American wealth and influence not about whats good for the future of the world. Australia will continue to pay a very high price for its blind alliance with the U.S.

Harquebus:

harvey:

21 Nov 2013 11:14:28am

This treaty is just another example of the reality that those who have the power always misuse it.

Most of the spying done by the USA is done not for military reasons, but to make absolutely sure that the USA companies are monopolies all over the world. The US govt undertakes massive industrial surveillance and espionage. And then they use these one sided treaties to legitimise their dominance.

Countries only have their economic and military boundaries to define them. Australia has half given away our military boundaries to the USA which has a massive spying station near Alice Springs, as well as a foothold in Darwin and other places. We have yet to find out whether this gives us any protection in the event of an attack on Australia by another country. For all we know the US would just wash its hands and walk away.

So now the US is wanting to control our economy. If they control our health care budget, then that will be a very good start. The existing Treaty signed by Howard was just them getting a foot into the door. They have a bit of the pie, but they won't stop until they own the whole pie.

The big push by Murdoch to get rid of the ALP govt and put Abbott in was orchestrated by him as a US citizen. The US Govt has the goods on Murdoch as regards phone hacking in the US, and while he does what they want they won't pull the plug on his empire. And he knows that.

Btw, Obama is being reported as getting increasingly cranky that we are taking so long to sign the TPP.